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Prevention & Control of Ebola: How doctors can avoid infection

This is a good time to sit back and thoroughly study Ebola prevention - especially now that the initial wave of infection has been controlled and preventive efforts are at the highest priority. The recent outbreak of Ebola has been proclaimed as the largest outbreak in history by the World Health Organisation (WHO) - the seriousness of the threat further magnified by its being labelled an international emergency. The reason Ebola has been labelled as an international emergency is that it is rapidly fatal, with a death rate of 70 - 90%. Ebola is a severe haemorrhagic illness caused by the Ebola virus, a Filovirus, leading to rapidly progressive organ failure and ultimately death. It is highly infectious and spread through direct contact with bodily fluids such as blood, saliva, urine, semen, etc. of an infected person, and by contact with contaminated surfaces or equipment, including linen soiled by bodily fluids from an infected person. Interestingly, it is relatively easy to prevent, as it can be easily eliminated with heat, alcohol-based products, and bleach or bleaching powder. This makes prevention the crux of all containment measures and this is particularly true for healthcare professionals who are at high risk for direct contact with those infected by this deadly virus.

Doctors working in Ebola-endemic areas can avoid this deadly infection by strictly following preventive measures as elucidated by the WHO. The following guidelines for doctors and other healthcare workers can play a major role in preventing this deadly infection:

Universal Precautions in Endemic Areas: In areas where Ebola outbreak is imminent or already raging, it is wise to strengthen and carefully apply standard precautions when providing care to ALL patients regardless of the signs and symptoms with which they present.

Create Isolation Rooms or Areas: Isolate suspected or confirmed haemorrhagic fever cases in SINGLE isolation rooms or enclose them in specific confined areas, while rigorously keeping suspected and confirmed cases separate. Restrict access to these areas and ensure dedicated equipment is made available for each suspected or confirmed patient.

Restrict Unnecessary Movement of Infected Patients: Only take any Ebola patient out of their isolation rooms or areas if they are free of the virus, or for essential, life-saving tests.

Personal Protective Equipment (PPE): Ensure that prior to entering the patient isolation rooms/areas, all visitors and healthcare workers, including doctors, rigorously use personal protective equipment (PPE) and perform hand hygiene. PPE should include at least gloves, a gown, boots/closed shoes with overshoes, mask and eye protection for splashes.

Limited Use of Needles and Sharps: Use injections and sharps to a bare minimum using all precautions, and perform phlebotomy procedures only when absolutely essential. Ensure safe processing of laboratory samples from suspected or confirmed patients with haemorrhagic fever. Dispose of needles and sharps safely.

Safe Waste Management and Cleaning of Environment: Ensure regular and rigorous environmental cleaning, decontamination of surfaces and equipment, and effective management of waste and soiled linen.

Safe Handling of Dead Bodies/Human Remains of Suspected or Confirmed Cases: Ensure that all infection prevention and control (IPC) measures are followed meticulously while handling dead bodies or human remains of suspected or confirmed patients with haemorrhagic fever, for post-mortem examination and burial preparation.

Isolation of Exposed Healthcare Personnel: Promptly evaluate, care for, and if necessary, isolate health-care workers or any person exposed to blood or body fluids from suspected or confirmed patients with haemorrhagic fever.

Finally, it can be said that early detection and prevention is almost the only cure when it comes to Ebola, as no specific vaccine or medicine has been proven to be effective against Ebola. Healthcare professionals, particularly doctors should be extra cautious while handling patients infected with this deadly virus, while also creating awareness about this looming threat.

The following are National Guidelines/Procedures for prevention, control and management of Ebola Virus Disease: